According to yesterday’s Dispatch, incoming House Finance Committee Chairman Ron Amstuz (R-Wooster) blames the federal government for not giving Ohio another dose of federal stimulus before “forcing” them into a round of painful budget cuts that very well politically doom the new Republican House majority back into the minority by 2012.

"We have to manage our way out of one-time funding, and it would help if they just didn’t shut it down in a couple months."

In other words, he’d like the State to ask for and receive additional stimulus money to balance the next budget.

This notion, that Ohio could use another round of federal stimulus money to balance its budget until the economy recovers enough to generate the revenues lost from the economic decline, was part of what Governor Strickland proposed.

Governor-elect Kasich called it going to Washington with a “tin cup.” Now, Kasich’s Republican allies in the General Assembly are starting to realize that tin cup may not be such a bad idea while Ohio’s economy is in recovery.

For every dollar Ohio cuts in Medicaid spending, it loses $2 in federal matching funds.

Which means every dollar you cut in state funding for Medicaid has a exponential cut in the amount of services Medicaid can provide in Ohio at a factor of three.

And as we mentioned early last week, who would get hit the hardest by Speaker-elect Batchelder’s planned budget cuts? Pregnant women, disabled people who are working, and children:

Again, incoming freshman Republican members like Dr. Terry Johnson who represents Scioto and parts of Lawrence County cannot be expected to vote in favor of large cuts to Medicaid. It’s a third-rail of politics.

The Dispatch notes that even if Ohio scrapped coverage for “optional services”—services that Ohio is not required by the federal government to include in its Medicaid—doesn’t necessary translate to savings?

Cutting services also can backfire. For example, if the state drops dental coverage, those in need of care are likely to seek it at hospital emergency rooms where the cost is higher and ultimately passed on to consumers with insurance.

Of course, that only affects the medical providers’ and insurance companies’ bottom line, not the State’s. So I’m somewhat unconvinced that you won’t see a major ax taking to the $3.4 billion in “optional” coverage Ohio currently provides through Medicaid.

It seems that more than one member of the Republican House caucus is already balking at Batchelder’s planned Medicaid cuts:

Rep. David E. Burke, R-Marysville, said he thinks the state can save the most by improving and streamlining the way services are delivered.

"I don’t think the heart of the issue rests with children or pregnant mothers," said Burke, a pharmacist. "It rests in other areas where we can save money. We need to look at the big picture."

Of course, Burke is living in a politician’s fantasy-land where you can cut billions in health care for the poor without actually affect the medical care for poor pregnant mothers or their children.

Amstutz, too, try to put his best spin on things, particularly on Medicaid:

“I’m convinced Medicaid can have some changes that will not hurt the folks that Medicaid serves. It will be one of the toughest areas we have."

…

"I think a good-faith effort will be made to not do the simplistic across-the-board cuts. I don’t think that’s good management. We’ll try to protect our highest-level services."

It looks like Speaker-elect Batchelder may have spoken out of school. It looks like prominent members of his own caucus are already publicly trying to distance themselves from Batchelder’s proposal.

We’ve yet to have heard definitively from our Governor-elect on the subject other than this bland quote from his campaign spokesman:

"Clearly, the rate of growth in Medicaid spending is unsustainable, so Medicaid, like every other state program, must be on the table in the budget process," Kasich spokesman Rob Nichols said.

Seriously, why do reporters allow Kasich get away with being this vague? We obviously have figured out given Speaker-elect’s comments last week that Medicaid is “on the table” for budget cuts. Acknowledging that is not news. What would be news if the incoming Administration would let us know precisely what regarding Medicaid is on the table.

I think those on Medicaid and the medical community kind of need some sense of what’s about to transpire before it’s due in March.